NHA CET 2025/2026 QUESTIONS AND SOLUTIONS
GRADED A+ TIP
✔✔Holter monitor - ✔✔Portable battery-operated device that continuously monitors
heart activity 24 hours or longer; also known as ambulatory monitor
✔✔event recorder - ✔✔Form of outpatient cardiac testing that involves the patient
triggering the machine to record when cardiac symptoms occur.
✔✔medical asepsis - ✔✔Practice designed to reduce the number and transfer of
pathogens, as well as break the chain of infection.
✔✔standard precautions - ✔✔The basic level of infection-control practices health care
workers must perform before, during, and after every encounter with patients to prevent
the spread of infection.
✔✔healthcare-associated infection (HAI) - ✔✔. Infection acquired via health care
workers or within the health care setting
✔✔personal protective equipment (PPE). - ✔✔Protective clothing and equipment
(gloves, mask, gown, goggles) designed to protect a worker from exposure to chemicals
or infectious material.
✔✔Guidelines regarding hand hygiene - ✔✔Good hand hygiene is the most important
thing that stops the cycle of infection. Both staff and patients benefit from this essential
safety practice. Excess jewelry (rings, bracelets) is discouraged because they can
harbor pathogens. If these are worn, remove them prior to hand hygiene for best
results. Health care workers should avoid artificial nails because they can harbor
pathogens and cause scratches or injury to patients. If there is no visible contamination
on health care workers' hands, an alcohol-based sanitizer may be used.
✔✔Steps for washing hands using soap and water - ✔✔1. Start by wetting hands with
clean, running, warm water. 2. Apply soap. 3. Rub hands together for at least 20
seconds, paying attention to all surfaces, including nails, between fingers, and the first
inch of the forearm. Friction helps lift debris from the skin. Microbes tend to concentrate
near and under the nails, so give special attention to these areas. 4. Rinse hands with
running water. 5. Dry with a clean towel or air-dry. 6. If using a standard faucet, use a
paper towel to shut the faucet off once the hands are clean and dry to avoid exposing
hands to a contaminated surface.
✔✔Steps for using an alcohol-based sanitizer - ✔✔If clean water and soap are not
available, an alcohol-based sanitizer with a minimum of 60% alcohol can be used. 1.
Apply a small amount (usually dime-sized) into the palm of one hand. 2. Rub hands
together, creating friction. 3. Make sure to cover all surfaces, including nails and
between fingers. 4. Continue rubbing until the solution has dried. Sanitizers can be a
,good solution in specific circumstances, but they should not be used if hands are visibly
dirty. Soap and water must be used to remove debris and wash the hands.
✔✔Sanitization - ✔✔Sanitization is often the first step in ensuring that a piece of
medical equipment is as clean as possible. This process reduces the number of
microbes so the equipment is ready for sterilization or disinfection. Sanitization is
especially helpful if there is visible debris on the equipment. Gloves must be worn
during this process. Employers are required to provide PPE (such as gloves) to health
care workers. If an employee is allergic to latex or the powder used in gloves, the
employer must provide hypoallergenic or powder-free gloves at no cost to the
employee. When determining that gloves are needed, also ask the patient about latex
allergies to avoid reactions.
✔✔Disinfection - ✔✔Disinfection is the process of destroying pathogens on a surface.
Even though it does not destroy all microbial spores, it greatly reduces the spread of
infection by limiting microbial activity. The solutions used in disinfection are effective
when used correctly. Chemical disinfectants cannot be used on patients; they are
reserved for medical supplies and equipment such as the electrocardiograph machine
and leads. To minimize the risk of spreading infection, the EKG machine, leads, and
exam table should be disinfected after each use
✔✔electrocardiograph machine - ✔✔Instrument that provides a graphic representation
of the electrical activity of the heart.
✔✔leads - ✔✔Wires that conduct electrical impulses from electrodes to an EKG
machine.
✔✔Disposal of biohazardous materials - ✔✔OSHA requires disposal of infectious and
hazardous waste according to safety standards. The use of PPE and Safety Data
Sheets (SDSs) provides health care workers with the tools and resources to maintain a
safe clinical work environment. The proper identification and disposal of contaminated
material is another step in preventing the spread of infectious material. When
performing cardiac testing, most materials can be disposed of in a regular waste can.
Only put items with body fluid into a biohazardous container. Dispose of any needles or
other sharps supplies used during a stress test injection in the appropriate sharps
container.
✔✔Safety Data Sheet (SDS). - ✔✔Documentation provided by manufacturers of
potentially harmful substances that lists chemical components, associated hazards, and
treatment in case of exposure.
✔✔Electronic health record - ✔✔Some EKG machines allow information to
automatically upload to patient files. Others require information to be scanned prior to
being added to the electronic health record (EHR). Adhere to your facility's policy
regarding EKG documentation. Ensure that patient identifiers have been entered. Verify
, that the EKG being attached to the record belongs to that patient. Follow established
policies and guidelines to prevent errors in medical record-keeping
✔✔When entering data in preparation for an EKG, typical patient information includes
the following. - ✔✔⦁ Name ⦁ Date of birth ⦁ Medications ⦁ Medical conditions ⦁ Vital
signs ⦁ Allergies ⦁ Provider ⦁ Date and time of the test
✔✔Artifacts - ✔✔Artifacts can occur from a variety of both patient and nonpatient
factors. The most common reasons for EKG artifacts caused by the patient involve body
movement or substances on the skin. Nonpatient causes include issues related to
mechanical and electrical factors. EKG machines are typically equipped with filters to
remove external interference. Make sure that the filter is turned on. The EKG technician
must be able to detect artifacts and then determine the cause to reduce or eliminate
them
✔✔Wandering baseline - ✔✔The baseline is the time between each cardiac cycle,
noted as a flat line, and is a time of repolarization (or relaxation). A wandering baseline
often appears on the EKG when the electrodes are improperly placed. A wandering
baseline is exactly what the name implies—the recording demonstrates wavelike up-
and-down movements throughout the tracing. The wandering baseline artifact can result
from a variety of causes.
✔✔What causes wandering baseline? - ✔✔Movement of the cables or leads during the
reading ⦁ Patient movement ⦁ Loose electrodes ⦁ Dry electrodes ⦁ Patient's labored
breathing ⦁ Improper skin preparation (leaving traces of lotion, oils, or gel on the skin)
An easy way to eliminate the wandering baseline is to reposition the limb leads and
ensure they are on fleshy areas.
✔✔To avoid many of the wandering baseline issues: - ✔✔Instruct the patient to make
sure the skin is free of topical substances. ⦁ Clean attachment sites prior to the
procedure. ⦁ Educate the patient on what to expect. ⦁ Provide clear directions on how to
breathe and when not to talk
✔✔baseline #2 - ✔✔. An electrically neutral area on the EKG; also referred to as the
isoelectric line or TP segment
✔✔repolarization - ✔✔The process of moving sodium from inside the cell to the outside,
and potassium from outside the cell to the inside; occurs during the heart's relaxation
phase
✔✔Somatic tremor - ✔✔Muscle movement on an EKG tracing is referred to as a
somatic tremor. Somatic tremor exhibits as uneven spikes on the EKG tracing. The
tremors are caused by multiple factors. What is causing the tremors will determine how
to troubleshoot the problem.
GRADED A+ TIP
✔✔Holter monitor - ✔✔Portable battery-operated device that continuously monitors
heart activity 24 hours or longer; also known as ambulatory monitor
✔✔event recorder - ✔✔Form of outpatient cardiac testing that involves the patient
triggering the machine to record when cardiac symptoms occur.
✔✔medical asepsis - ✔✔Practice designed to reduce the number and transfer of
pathogens, as well as break the chain of infection.
✔✔standard precautions - ✔✔The basic level of infection-control practices health care
workers must perform before, during, and after every encounter with patients to prevent
the spread of infection.
✔✔healthcare-associated infection (HAI) - ✔✔. Infection acquired via health care
workers or within the health care setting
✔✔personal protective equipment (PPE). - ✔✔Protective clothing and equipment
(gloves, mask, gown, goggles) designed to protect a worker from exposure to chemicals
or infectious material.
✔✔Guidelines regarding hand hygiene - ✔✔Good hand hygiene is the most important
thing that stops the cycle of infection. Both staff and patients benefit from this essential
safety practice. Excess jewelry (rings, bracelets) is discouraged because they can
harbor pathogens. If these are worn, remove them prior to hand hygiene for best
results. Health care workers should avoid artificial nails because they can harbor
pathogens and cause scratches or injury to patients. If there is no visible contamination
on health care workers' hands, an alcohol-based sanitizer may be used.
✔✔Steps for washing hands using soap and water - ✔✔1. Start by wetting hands with
clean, running, warm water. 2. Apply soap. 3. Rub hands together for at least 20
seconds, paying attention to all surfaces, including nails, between fingers, and the first
inch of the forearm. Friction helps lift debris from the skin. Microbes tend to concentrate
near and under the nails, so give special attention to these areas. 4. Rinse hands with
running water. 5. Dry with a clean towel or air-dry. 6. If using a standard faucet, use a
paper towel to shut the faucet off once the hands are clean and dry to avoid exposing
hands to a contaminated surface.
✔✔Steps for using an alcohol-based sanitizer - ✔✔If clean water and soap are not
available, an alcohol-based sanitizer with a minimum of 60% alcohol can be used. 1.
Apply a small amount (usually dime-sized) into the palm of one hand. 2. Rub hands
together, creating friction. 3. Make sure to cover all surfaces, including nails and
between fingers. 4. Continue rubbing until the solution has dried. Sanitizers can be a
,good solution in specific circumstances, but they should not be used if hands are visibly
dirty. Soap and water must be used to remove debris and wash the hands.
✔✔Sanitization - ✔✔Sanitization is often the first step in ensuring that a piece of
medical equipment is as clean as possible. This process reduces the number of
microbes so the equipment is ready for sterilization or disinfection. Sanitization is
especially helpful if there is visible debris on the equipment. Gloves must be worn
during this process. Employers are required to provide PPE (such as gloves) to health
care workers. If an employee is allergic to latex or the powder used in gloves, the
employer must provide hypoallergenic or powder-free gloves at no cost to the
employee. When determining that gloves are needed, also ask the patient about latex
allergies to avoid reactions.
✔✔Disinfection - ✔✔Disinfection is the process of destroying pathogens on a surface.
Even though it does not destroy all microbial spores, it greatly reduces the spread of
infection by limiting microbial activity. The solutions used in disinfection are effective
when used correctly. Chemical disinfectants cannot be used on patients; they are
reserved for medical supplies and equipment such as the electrocardiograph machine
and leads. To minimize the risk of spreading infection, the EKG machine, leads, and
exam table should be disinfected after each use
✔✔electrocardiograph machine - ✔✔Instrument that provides a graphic representation
of the electrical activity of the heart.
✔✔leads - ✔✔Wires that conduct electrical impulses from electrodes to an EKG
machine.
✔✔Disposal of biohazardous materials - ✔✔OSHA requires disposal of infectious and
hazardous waste according to safety standards. The use of PPE and Safety Data
Sheets (SDSs) provides health care workers with the tools and resources to maintain a
safe clinical work environment. The proper identification and disposal of contaminated
material is another step in preventing the spread of infectious material. When
performing cardiac testing, most materials can be disposed of in a regular waste can.
Only put items with body fluid into a biohazardous container. Dispose of any needles or
other sharps supplies used during a stress test injection in the appropriate sharps
container.
✔✔Safety Data Sheet (SDS). - ✔✔Documentation provided by manufacturers of
potentially harmful substances that lists chemical components, associated hazards, and
treatment in case of exposure.
✔✔Electronic health record - ✔✔Some EKG machines allow information to
automatically upload to patient files. Others require information to be scanned prior to
being added to the electronic health record (EHR). Adhere to your facility's policy
regarding EKG documentation. Ensure that patient identifiers have been entered. Verify
, that the EKG being attached to the record belongs to that patient. Follow established
policies and guidelines to prevent errors in medical record-keeping
✔✔When entering data in preparation for an EKG, typical patient information includes
the following. - ✔✔⦁ Name ⦁ Date of birth ⦁ Medications ⦁ Medical conditions ⦁ Vital
signs ⦁ Allergies ⦁ Provider ⦁ Date and time of the test
✔✔Artifacts - ✔✔Artifacts can occur from a variety of both patient and nonpatient
factors. The most common reasons for EKG artifacts caused by the patient involve body
movement or substances on the skin. Nonpatient causes include issues related to
mechanical and electrical factors. EKG machines are typically equipped with filters to
remove external interference. Make sure that the filter is turned on. The EKG technician
must be able to detect artifacts and then determine the cause to reduce or eliminate
them
✔✔Wandering baseline - ✔✔The baseline is the time between each cardiac cycle,
noted as a flat line, and is a time of repolarization (or relaxation). A wandering baseline
often appears on the EKG when the electrodes are improperly placed. A wandering
baseline is exactly what the name implies—the recording demonstrates wavelike up-
and-down movements throughout the tracing. The wandering baseline artifact can result
from a variety of causes.
✔✔What causes wandering baseline? - ✔✔Movement of the cables or leads during the
reading ⦁ Patient movement ⦁ Loose electrodes ⦁ Dry electrodes ⦁ Patient's labored
breathing ⦁ Improper skin preparation (leaving traces of lotion, oils, or gel on the skin)
An easy way to eliminate the wandering baseline is to reposition the limb leads and
ensure they are on fleshy areas.
✔✔To avoid many of the wandering baseline issues: - ✔✔Instruct the patient to make
sure the skin is free of topical substances. ⦁ Clean attachment sites prior to the
procedure. ⦁ Educate the patient on what to expect. ⦁ Provide clear directions on how to
breathe and when not to talk
✔✔baseline #2 - ✔✔. An electrically neutral area on the EKG; also referred to as the
isoelectric line or TP segment
✔✔repolarization - ✔✔The process of moving sodium from inside the cell to the outside,
and potassium from outside the cell to the inside; occurs during the heart's relaxation
phase
✔✔Somatic tremor - ✔✔Muscle movement on an EKG tracing is referred to as a
somatic tremor. Somatic tremor exhibits as uneven spikes on the EKG tracing. The
tremors are caused by multiple factors. What is causing the tremors will determine how
to troubleshoot the problem.
